NPI | 1861847741 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH60691222) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 33551) |
Enumeration Date | 2016-04-28 |
Last Update Date | 2021-04-05 |